High Blood Pressure in PregnancyKatlyn Joy |31, May 2011
Blood Pressure Basics
Blood pressure measures how hard blood presses against your artery walls as it pumps through your body. Blood pressure is measured in two numbers. The top number, or systolic, measures during the body's pumping of blood. The top number is considered too high if over 140. The bottom number or diastolic, measures the pressure when the heart is at rest and fills with blood. The diastolic number should stay under 90. High blood pressure is indicated when either or both numbers is higher than these standards. High blood pressure is also called hypertension.
High blood pressure can be temporary, and generally some rises and falls in blood pressure throughout the day are normal such as increases when under stress or during exercise and dips during rest. These normal swings are nothing to be concerned about. It is only when the blood pressure readings are consistently high or dramatically high.
Chronic Hypertension During Pregnancy
Chronic hypertension is when high blood pressure occurs before becoming pregnant. For those who know they suffer from hypertension, it is important to get medical supervision early in pregnancy. High blood pressure can create dangerous situations for both mother and child.
If you take medication to control your high blood pressure, under your doctor's advice you might be able to stop prescription drugs during pregnancy. However some women must control to take medicine to control their condition throughout the pregnancy. Sometimes a different medication may be used since it is safer to use in pregnancy.
Medications that are generally avoided during pregnancy include angiotensin receptor blockers (ARBs), renin inhibitors and angiotensin-converting enzyme (ACE) inhibitors.
If you have hypertension and are contemplating becoming pregnant you should work to control your blood pressure. Eat a healthy diet, exercise, keep your weight at a healthy level and avoid tobacco and alcohol. Consult with your physician to determine if you'll need to switch prescriptions when you start trying to get pregnant.
This condition occurs when high blood pressure develops after the 20th week of pregnancy. It differs from pre-eclampsia because there is no protein present in the woman's urine as in pre-eclampsia. Gestational hypertension generally disappears after giving birth. It's normal for a woman's blood pressure to drop during the second trimester and rise back to normal at the end of pregnancy. However, some women will experience a rise in blood pressure in the second and final trimesters. This is gestational hypertension.
Pre-eclampsia is a condition that is indicated by the presence of protein in the urine (one of the reasons you have to pee in that cup at every prenatal visit) and high blood pressure. This condition is serious and must be monitored to insure it doesn't develop into the life-threatening condition of eclampsia. Eclampsia causes stroke or even coma but is rare when women receive proper prenatal care.
Symptoms of pre-eclampsia include headaches, vision problems like blurred vision, floaters, or sensitivity to light, abdominal pain particularly in the upper right side of the tummy, sudden weight gain, and swelling especially in the hands and face.
Risk factors for pre-eclampsia include having chronic hypertension, previous diagnoses of pre-eclampsia, those who were significantly overweight prior to pregnancy, those who are older than 40 or under 20 years of age, women with conditions such as diabetes, kidney conditions, rheumatoid arthritis or lupus.
Problems with high blood pressure in pregnancy occurs in about 6 to 8 percent of pregnancies. Of these, 70 percent were first-time pregnancies. Overall, pre-eclampsia cases have increased in the US with multiple births and the rise in the number of older mothers.
High blood pressure can reduce the blood flow to the placenta which decreases the oxygen and nutrients delivered to the fetus. This may slow the baby's growth or cause low-birth weight.
Placental abruption, or the premature rupture of the placenta from the uterine wall, may occur with high-blood pressure. This deprives baby of nutrients and oxygen and causes hemorrhaging in the mother.
Premature delivery may be necessary to save the mother and baby's life. However, if the delivery is necessary too early in the pregnancy, the fetus may not survive.
Stillbirth is possible as well with high blood pressure in pregnancy.
For those with chronic hypertension, taking medication as directed and following any particularly medical orders such as limiting salt intake is important. Even more important is regular prenatal visits.
For those with pre-eclampsia, it is important to go to all doctor's appointments and get the urine screened for protein and blood pressure readings. Sometimes bedrest or hospitalization is required if the blood pressure levels are too high.
However the only cure for pre-eclampsia is delivery of the baby. Doctors will determine when the blood pressure levels are too high to be safe for mother and baby to continue the pregnancy any longer. The baby will be delivered either by inducing labor or through a cesarean section. If the baby must be delivered too early in the pregnancy, the hospital will be prepared to care for the premature infant.
Long Term Issues
For most women who experience high blood pressure during pregnancy, normal blood pressure will be resumed after birth or within several weeks. However, some women may have had undiagnosed high blood pressure prior to getting pregnant and may continue to need treatment for hypertension following delivery.
According to the National High Blood Pressure Education Program, pre-eclampsia does not generally indicate that the woman will later have chronic hypertension or heart-related problems.
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